| Intraindividual comparison of gadolinium- and iodine-enhanced 64-slice multidetector CT pulmonary angiography for the detection of pulmonary embolism in a porcine model. | |
| | |
MedLine Citation:
|
PMID: 21136130 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
This study is an evaluation of the diagnostic accuracy of gadolinium-enhanced computed tomography pulmonary angiography (CTPA) for the detection of pulmonary embolism (PE) in comparison with iodine-enhanced CTPA. PE was induced in five anesthetized pigs by administration of blood clots through an 11-F catheter inside the jugular vein. Animals underwent CTPA in breathhold with i.v. bolus injection of 50 ml gadopentetate dimeglumine (0.4 mmol/kg, 4 ml/s). Subsequently, CTPA was performed using the same imaging parameters but under administration of 70 ml nonionic iodinated contrast material (400 mg/ml, 4 ml/s). All images were reconstructed with 1 mm slice thickness. A consensus readout of the iodium-enhanced CTPAs by both radiologists served as reference standard. Gadolinium-enhanced CTPAs were evaluated independently by two experienced radiologists, and differences in detection rate between both contrast agents were assessed on a per embolus basis using the Wilcoxon signed-rank test. Interobserver agreement was determined by calculation of қ values. PE was diagnosed independently by both readers in all five pigs by the use of gadolinium-enhanced CTPA. Out of 60 pulmonary emboli detected in the iodine-enhanced scans, 47 (78.3%; reader 1) and 44 (62.8%; reader 2) emboli were detected by the use of gadolinium. All 13 (100%) emboli in lobar arteries (by both readers) and 26 (reader 1) and 25 (reader 2) out of 27 emboli (96.3% and 92.6%) in segmental arteries were detected by the use of the gadolinium-enhanced CTPA. In subsegmental arteries, only 8 (40%; reader 1) and 6 (30%; reader 2) out of 20 emboli were detected by the gadolinium-enhanced CTPA. By comparing both scans on a per vessel basis (Wilcoxon test), Gd-enhanced CTPA was significantly inferior in emboli detection on subsegmental level (P < 0.0001). The interobserver agreement was excellent on lobar and segmental level (қ = 1.0 and 0.93, respectively), whereas readers only reached moderate agreement for PE evaluation on subsegmental level (қ = 0.56). Compared to conventional CTPA with iodinated contrast media, gadolinium-based contrast agents achieve an equivalent diagnostic accuracy in detection of PE down to segmental level. Gadolinium-enhanced CTPA may be considered as an alternative for the diagnostic workup of acute pulmonary embolism in patients with contraindications to iodinated contrast agents. |
| | |
Authors:
|
Frank Oliver Gerhard Henes; Michael Groth; Philipp G C Begemann; Gerhard Adam; Marc Regier |
Publication Detail:
|
Type: Journal Article Date: 2010-12-07 |
Journal Detail:
|
Title: Emergency radiology Volume: 18 ISSN: 1438-1435 ISO Abbreviation: Emerg Radiol Publication Date: 2011 Jun |
Date Detail:
|
Created Date: 2011-05-18 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9431227 Medline TA: Emerg Radiol Country: United States |
Other Details:
|
Languages: eng Pagination: 189-95 Citation Subset: IM |
Affiliation:
|
Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany, f.henes@uke.uni-hamburg.de. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: C-reactive protein in relation to early atherosclerosis and periodontitis.
Next Document: Blue toe syndrome and sunitinib.